Two Norwegian researchers offer a very thoughtful essay in the current PLoS Medicine.
They describe different countries' differing policies on colorectal cancer screening -- from simply screening everyone or none at all. Meantime, the benefits of screening and the ideal screening method, have not been clearly established.
Or nations could do what the Finns have done -- with a stepwise, randomized trial, allowing evaluation of its fecal occult blood test screening program after five years before deciding what their next step of action should be. The authors write: "The people behind the Finnish strategy deserve credit for persuading their politicians to choose this cautious, stepwise model, and the politicians and health authorities deserve credit for listening. In the Finnish model, half of each age cohort is randomised to screening or no screening. The Finnish model must have required a lot of explanation to authorities that this approach was clearly the best way to proceed. It was, of course, risky for politicians to voluntarily throw away half (or more) of their target candidate supporters by declaring, in essence, 'We believe in (colorectal cancer) screening, but aren't sure about it, and half of you will be offered screening while the other half will not.' "
Finally, with a shot at celebrities like Katie Couric who use their platform to promote screenings for which not all the evidence is in, the authors write: "Health policymakers must also remain sceptical of the role of celebrity endorsements. Communication on complex decisions such as cancer screening, with an aim to inform rather than persuade, is not an obvious task for celebrities."
Posted by schwitz at January 3, 2006 05:02 PM | TrackBack